I just realized something

I just realized something. Last session or maybe the one before, T gave me a diagnosis. He's never done that before. We've worked on doing what I needed to do in order to heal, and weren't concerned with labels. Of course, I probably have multiple things going on (e.g. I had major depression, which I worked on with my previous T), but what he said was PTSD. I basically ignored it when he said that and he didn't push it on me and conversation continued on to something else. I feel a little strange about this. I can certainly see that my childhood trauma is a root of many current problems. I looked up the diagnostic criteria for PTSD, and I have all of them. I guess this is no surprise to me, as we have done EMDR and trauma work in therapy. It just feels strange to have him say "PTSD" to me.

Hmmmm...
are you ok with it?

That is the only label my t will use too. it frustrates me some since i want to talk about the parts and such. but everything i say goes back with her to ptsd.

maybe it is just strange to have something so concrete?


kiya

(((((((((((((((((( sunrise )))))))))))))))))))

I felt really weird when I got that diagnosis too. But, of course, it's nothing but a word....you're still you.

I guess it does put some things in context sometimes - like something will happen, and T will say "that's common in PTSD" and I'll feel a little less crazy. That helps.

Thanks Kiya and Earthmama.

Yes, I'm OK with the diagnosis--it's not like I never knew I had experienced trauma. It just made it seem a bit clinical and impersonal to hear those words--PTSD--roll off of T's tongue. We usually don't talk clinical at all. It made me feel more like a "patient" than a "client," and less of a mutual partner in my therapy. It was subtle and not really bothersome, but yet something inside me sat up and took notice.

Sunrise, that makes sense.

My t is much the same and when she said to me "You are our residential DID expert" i felt the same way. Though first I felt embarassed, but when the meaning sunk in, it felt different. I like how you phrased it; "something inside me sat up and took notice."

Yeah I don't know what it is about a diagnosis. I'm with you, it isn't necessary since it doesn't change the work.

I had done a lot of reading and one diagnosis kept grabbing my attention. The more I read the more it fit, until I brought it up in session and asked T what she thought, if she thought it applied to me. She did and had thought that for some time. At first it was relieving, then it was troubling. Like earthmama, I feel like it let me off the hook. Instead of feeling intrinsically defective, I now know that there are reasons I am the way I am and that the fact other people don't have to struggle with the same things doesn't make me a freak, like I've felt all my life.

T later said "I don't want you to get hung up on that" (the diagnosis) and that was good to hear that she isn't defining me by it and won't let me do that to myself either.

But yeah, something about it 'landing' on us, being not just another term but really about us....very different light is cast there for a bit.

sunny,

ECHOES

I am still wishing I didn't ask for my dx the other session. Made me feel a lot worse about seeking help.

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It just made it seem a bit clinical and impersonal to hear those words--PTSD--roll off of T's tongue.

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Did you feel as though it was a reminder that the relationship is a therapeutic relationship?

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chaotic13 said:
Did you feel as though it was a reminder that the relationship is a therapeutic relationship?

</div></font></blockquote><font class="post">No, not at all, because I adore the therapeutic relationship. It has been such a positive in my life. His giving a diagnosis just made it seem so clinical, and I have never perceived him as clinical before. Also, it brought home to me that he sees me as having a problem/pathology so that makes me see myself that way too, whereas I usually think of myself as fine, just working with him on some difficult life issues. Kind of burst my bubble a bit that I was "normal", whatever that means.

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he sees me as having a problem/pathology

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This is what I meant. Simple friendships can be therapeutic at times but their purpose is not strictly for this. You can call up and just hang out or chat with a friend for no real purpose other than you want company. The purpose of our interaction with our T is to help us deal with specific things (divorce,PTSD, depression, etc). Although you might be able to create a temporary environment with your T that feels like you are just going there to chat and catch up on things, you really aren't. You are a patient with some pathology and he is a T. The chatting has a underling purpose. There is nothing wrong with that, it is just what it is.

I have never confused my therapist with a friend and have never wanted him to be my friend. I have always felt I went to see my therapist to heal, and that meant resolving issues past and present--never just to chat and catch up on things! (Others may view their therapeutic relationship like that, but not me--for one thing, since I pay 100% out of pocket, it's too expensive to just chat.) But I guess I viewed myself as wounded, rather than with a condition with a clinical name. But I guess it really is just the same--just semantics, I guess. (My T has said several times before that I am very sensitive to the nuances of language, and he tends to be too, so we are a good match that way.) I really like the therapeutic relationship just the way it is and really like being my T's client (not patient).

Objectivity is so very important in the theraputic relationship/process..

You have found the value added aspect of therapy in the "using" of its service for your purpose...to heal.

Many folks enter therapy with a plethora of issues,,lonliness being one. Having an exclusive audience for a prescribed time is tempting to solve the pain of lonliness at the cost of finding solutions to more profound problems...

You've done well sunrise and its also worth mentioning that the temptation is just as difficult for the professional when a wonderfull patient sits with them...

IMHO.

Lenny

Sunrise,
I know you are very grounded in how you see your relationship. If I recall you were one of the people who helped me generate a healthy perspective on my therapeutic relationship. I was viewing too rigidly as a PATIENT : therapist and needed to relax a bit. I guess I maybe was projection unintentionally projecting a bit. Sorry

I like your statement about client vs. patient. You are not your pathology.

This may not be in your case but often T's use PTSD for insurance purposes too. It covers more sessions. I don't remember if you were going through insurance or not.

I was just reading this disturbing article about managed care and what therapists are forced to do...horrifying.

http://www.sccs.swarthmore.edu/org/t...002.Cohen.html

Here is that long article about therapists, diagnoses and managed care impact. It is very eye opening

My T keeps telling me not to get hung up on diagnostic labels, she says they're nothing more than a useful shorthand for communicating with other psych professionals. But I kind of like having a Dx because it gives me a framework for understanding what I'm going through and I feel if I know what I have I can research it and proactively search out help. I still get a little freaked out seeing my Dx's laid out in black and white when my pdoc had to write a letter to the ministry of transportation re my fitness to drive, and having my treatment history spelt out felt sort of weird, an "oh yeah, I really have been through all of that." But the only time I got really freaked out / pissed off by a Dx was when I had to see a temporary pdoc, because my regular pdoc was off on medical leave. I was in his office for all of 10 minutes before he announced I was borderline (I'm convinced simply because I admitted to cutting) he clearly hadn't read my chart that my pdoc had sent over. When I told my pdoc she was really pissed too. And I made a point of going through reviewing my file and making sure that the borderline label wasn't written down anywhere.

--splitimage

what's wrong with borderline?

Funny how words can create realms of meaning that differ from person to person.

So, as opposed to you Sunny, I like the idea of being T's patient. Maybe it's because it feels "caring" to me not because it makes me feel sick or anything. Client sounds cold to me--almost lawyerly.

I feel tremendously grounded in our relationship and I like chatting and catching up at times. I think that I couldn't do that if our relationship weren't as connected as it is. But again, I think this is a difference in perspective of the concept of chatting and catching up. I don't do that easily or with people I don't care about. So, if I were to chat with T, it would be meaningful to me.

I have also recently received a dx of "complex ptsd." It came up in session. T said was the topic of complex ptsd came up at his study group and he said he thought of me and how it would explain our frequent ruptures since I have so many triggers and we keep falling into them. It wasn't like it was "Diagnosis Day" at therapy or anything.


I know that for insurance purposes he puts dysthymia because I looked up the code but we never discussed it per se. I also crash into major depression periodically and pdoc uses that dx.

Frankly, I don't think of myself as any of these things. But if it helps others to help me then it's okay.

Echoes, I don't think there is anything wrong with borderline, or any other dx for that matter.

In fact, I think we are all awesome!

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ECHOES said:
what's wrong with borderline?

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<font color="blue"> It is commonly known within the fields of mental health, that person's diagnosed either correctly or incorrectly with BORDERLINE PERSONALITY DISORDER, are often discriminated against by both the medical/psychiatric and psychological establishments.

It is very strange indeed, that even mental health professionals, who are supposed to be non-judgmental and provide professional treatment, will engage in maltreatment and discrimination of persons with the Borderline Personality Disorder dx.

Many unethical and/or inadequately trained mental health professionals will often label a so-called "difficult to treat" patient with a personality disorder dx, the most common of all misapplied/inappropriately used personality disorder diagnosis being Borderline Personality Disorder.

There is a big discussion within the board commissioned with formulating the new mental health diagnostic handbook, the DSM-V, due out in 2009 or 2010, with changing the name and diagnostic criteria of Borderline Personality Disorder, as they are acutely aware the currents problems the label creates. In fact, the discussion is leaning toward changing much of the criteria of the current personality disorder diagnosis categories.

I'm very lucky that thus far in my journey's, I haven't had anyone attempt to diagnose me with a personality disorder that I don't have (I don't have any, thank goodness). It's very hard to find good mental health professionals these days. </font>